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As I read the final communiqué from the G8 Summit in Lough Erne, Ireland, I was struck by the virtual silence on global health and development. This absence is especially unfortunate given that one of the G8’s long-standing health priorities, polio eradication, is at a critical juncture. As we enter the final chapter of this disease, the G8’s support is needed now more than ever.
In Kananaskis, Canada in 2002, G8 leaders committed for the first time to eradicating polio to protect all children worldwide. As Canada’s Minister of Finance during the Summit’s planning stages, I was eager to see the G8 take on an issue close to my heart: having survived polio as a child, and as the son of another survivor, I know firsthand what this disease can mean. I was honored to be at the 2004 Summit, this time as Canada’s Prime Minister, when the G8 pledged to “take all necessary steps to eradicate polio.”
To this day, the G8 has stood firm in its leadership on eradication, reaffirming its support at Summits in France and the United States. Collectively, G8 countries have contributed or pledged nearly US$4.6 billion between 1985 and 2014, as well as 18 per cent of the eradication program’s 2013 budget. Canada has been at the forefront of the effort as the fifth largest public sector donor to the program, having contributed more than US$360 million and recently pledging an additional US$250 million.
As the eradication effort comes to a turning point, the G8’s continued investment has never been more critical. In 2012, there were fewer polio cases in fewer countries than ever before, with just three remaining endemic countries. India, once projected to be the last polio reservoir, is going on two and a half years free of wild poliovirus. We are, at last, close to the end.
But the final stretch is undoubtedly the most difficult. Insecurity continues to prevent vaccinators from reaching children in the corners where polio persists. Just last week, we saw another chilling attack on two polio workers in Pakistan. A new outbreak in the Horn of Africa has resulted in at least 25 cases so far. Overcoming these obstacles calls for new approaches and unconventional thinking, combined with an unprecedented level of international collaboration and commitment.
The Global Polio Eradication Initiative (GPEI) – the partnership which has spearheaded polio eradication efforts since 1988 – has stepped up to the challenge with its new Polio Eradication and Endgame Strategic Plan to reach eradication by 2018. The plan lays out a strategy to interrupt wild poliovirus by the end of 2014, while also preparing for a global switch to the inactivated version of the vaccine and planning for polio’s legacy. The plan received an important seal of approval at the Global Vaccine Summit in April, when a wide range of donors – including four G8 governments – pledged more than three-quarters of the plan’s US$5.5 billion budget.
As a former finance minister, I’m impressed by the care taken in modeling the road to eradication. The plan’s budget is economical but realistic, and takes into consideration possible setbacks, including imperfect access and possible outbreaks. But the plan’s success relies on full upfront funding, which will give the GPEI the certainty and flexibility to effectively respond to sudden challenges without compromising long-term priorities. In the past, partial funding has forced the GPEI to make painful choices that cut or delay vaccination campaigns, leading to outbreaks and increasing the overall cost of eradication.
The current outbreak in the Horn of Africa is a prime example of the importance of full funding. Effective planning and available resources have enabled perhaps the most rapid outbreak response yet: within just five days of confirming the first polio case in Somalia, a high-risk region, hundreds of health workers were mobilized and vaccinating hundreds of thousands of children. Most importantly, the GPEI and country governments are executing this response without letting up on the primary challenge: interrupting transmission in the three remaining endemic countries.
This outbreak also demonstrates the importance of strengthening routine immunization, which helps raise population immunity levels to the threshold necessary to prevent polio outbreaks. The new Strategic Plan calls for this, too: in ten high-risk countries, the plan commits half of all personnel’s time to strengthening immunization systems, thus advancing eradication while creating a legacy that will continue to improve children’s health for years to come.
Now is the time to deliver on our promises and strengthen our commitment. We look to Canada and the G8 to continue as leaders in this effort and to follow through on the pledge we first made at that Kananaskis Summit. As the G20 Leaders gather in Russia this September they too must prioritize polio. Indeed its eradication requires the commitment of the entire global community.
Together, we can end polio and leave behind a truly remarkable legacy.
Paul Martin is the former prime minister of Canada. The opionions expressed in this op/ed are his own.